What is Melanoma?
Melanoma, the most serious type of skin cancer, develops in the cells that produce melanin -- the pigment that gives your skin its color. Melanoma can also form in your eyes and, rarely, in internal organs, such as your intestines.
The exact cause of all melanomas is not clear, but exposure to ultraviolet (UV) radiation from sunlight or tanning lamps and beds increases your risk of developing melanoma. Other factors, such as your genetic makeup, likely also play a role.
Limiting your sun exposure and avoiding tanning lamps and beds can help reduce your risk of melanoma. And making sure you know the warning signs of skin cancer can help ensure that cancerous changes are detected and treated before the cancer has a chance to spread. Melanoma can be treated successfully if it is detected early.
Melanomas can develop anywhere on your body, but they most often develop in areas that have had exposure to the sun, such as your back, legs, arms and face. Melanomas can also occur in areas that do not receive much sun exposure, such as the soles of your feet, palms of your hands and on fingernail beds. These hidden melanomas are more common in people with darker skin.
The first melanoma symptoms often are:
1)A change in an existing mole
2)The development of a new, unusual-looking growth on your skin
Melanoma does not always begin as a mole. It can also occur on otherwise normal-appearing skin.
Normal moles are generally a uniform color, such as tan, brown or black, with a distinct border separating the mole from your surrounding skin. They are oval or round and usually smaller than 1/4 inch (6 millimeters) in diameter -- the size of a pencil eraser.
Most people have between 10 and 40 moles. Many of these develop by age 40, although moles may change in appearance over time -- some may even disappear with age.
Unusual moles that may indicate melanoma
Characteristics of unusual moles that may indicate melanomas or other skin cancers follow the A-B-C-D-E guide developed by the American Academy of Dermatology:
A is for asymmetrical shape. Look for moles with irregular shapes, such as two very different-looking halves.
B is for irregular border. Look for moles with irregular, notched or scalloped borders -- characteristics of melanomas.
C is for changes in color. Look for growths that have many colors or an uneven distribution of color.
D is for diameter. Look for new growth in a mole larger than about 1/4 inch (6 millimeters).
E is for evolving. Look for changes over time, such as a mole that grows in size or that changes color or shape. Moles may also evolve to develop new signs and symptoms, such as new itchiness or bleeding.
Other suspicious changes in a mole may include:
3)Spreading of pigment from the mole into the surrounding skin
4)Oozing or bleeding
Cancerous (malignant) moles vary greatly in appearance. Some may show all of the changes listed above, while others may have only one or two unusual characteristics.
Melanomas can also develop in areas of your body that have little or no exposure to the sun, such as the spaces between your toes and on your palms, soles, scalp or genitals. These are sometimes referred to as hidden melanomas, because they occur in places most people would not think to check. When melanoma occurs in people with darker skin, it is more likely to occur in a hidden area.
Hidden melanomas include:
1)Melanoma under a nail. Subungual melanoma is a rare form that occurs under a nail and can affect the hands or the feet. It is more common in blacks and in other people with darker skin pigment. The first indication of a subungual melanoma is usually a brown or black discoloration that is often mistaken for a bruise (hematoma).
2)Melanoma in the mouth, digestive tract, urinary tract or vagina. Mucosal melanoma develops in the mucous membrane that lines the nose, mouth, esophagus, anus, urinary tract and vagina. Mucosal melanomas are especially difficult to detect because they can easily be mistaken for other, far more common conditions. A melanoma in a womans vagina can cause itching and bleeding. Anal melanoma can cause anal bleeding and pain during bowel movements. Melanoma that occurs in the esophagus can cause difficulty swallowing.
3)Melanoma in the eye. Eye melanoma, also called ocular melanoma, occurs in the uvea -- the layer beneath the white of the eye (sclera). An eye melanoma may cause vision changes and may be diagnosed during an eye exam.
Melanoma occurs when something goes awry in the melanin-producing cells (melanocytes) that give color to your skin. Normally, skin cells develop in a controlled and orderly way -- healthy new cells push older cells toward your skins surface, where they die and eventually are sloughed off. But when some cells develop DNA damage, new cells may begin to grow out of control and can eventually form a mass of cancerous cells.
Just what damages DNA in skin cells and how this leads to melanoma is not clear. It is likely that a combination of factors, including environmental and genetic factors, causes melanoma. Still, doctors believe exposure to ultraviolet (UV) radiation from the sun and from tanning lamps and beds is the leading cause of melanoma.
UV light does not cause all melanomas, especially those that occur in places on your body that don't receive exposure to sunlight. This indicates that other factors may contribute to your risk of melanoma.
Western Medicine Treatment
The best treatment for you depends on your stage of cancer and your age, overall health and personal preferences.
Treating early-stage melanomas
Treatment for early-stage melanomas usually includes surgery to remove the melanoma. A very thin melanoma may have been entirely removed during the biopsy and require no further treatment. Otherwise, your surgeon will remove the cancer as well as a small border of normal skin and a layer of tissue beneath the skin. For people with early-stage melanomas, this may be the only treatment needed.
Treating melanomas that have spread beyond the skin
If melanoma has spread beyond the skin, treatment options may include:
1)Surgery to remove affected lymph nodes. If melanoma has spread to nearby lymph nodes, your surgeon may remove the affected nodes. Additional treatments before or after surgery may also be recommended.
2)Chemotherapy. Chemotherapy uses drugs to destroy cancer cells. Chemotherapy can be administered intravenously, in pill form or both, so that it travels throughout your body. Or chemotherapy can be administered in a vein in your arm and leg in a procedure called isolated limb perfusion. During this procedure, blood in your arm or leg is not allowed to travel to other areas of your body for a short time, so that the chemotherapy drugs travel directly to the area around the melanoma and do not affect other parts of your body.
3)Radiation therapy. This treatment uses high-powered energy beams, such as X-rays, to kill cancer cells. It is sometimes used to help relieve symptoms of melanoma that has spread to another organ. Fatigue is a common side effect of radiation therapy, but your energy usually returns once the treatment is complete.
4)Biological therapy (immunotherapy). Biological therapy boosts your immune system to help your body fight cancer. These treatments are made of substances produced by the body or similar substances produced in a laboratory. Biological therapies used to treat melanoma include interferon and interleukin-2. Side effects of these treatments are similar to those of the flu, including chills, fatigue, fever, headache and muscle aches.
Experimental melanoma treatments
Clinical trials are studies of new treatments for melanoma. Doctors use clinical trails to determine whether a treatment is safe and effective. People who enroll in clinical trials have a chance to try evolving therapies, but a cure is not guaranteed. And sometimes the potential side effects are not known.
Some melanoma treatments being studied in clinical trials include:
Combining chemotherapy and biological therapy. Combining chemotherapy and biological therapy drugs may increase the success of both of these treatments. However, combining treatments can make severe side effects more likely.
Targeted therapy. Targeted therapies interrupt a specific process in cancer cells in order to control cancer. For instance, targeted drugs designed to stop melanoma from attracting blood vessels have been tested. Melanoma needs blood vessels to deliver nutrients and it uses blood vessels to spread cancer cells throughout the body. A drug that stops this process could cause a melanoma to remain small and localized. In another approach, specific chemicals that stimulate cancer cells to grow rapidly could be inactivated.
Vaccine treatment. Vaccines for treating cancer are different from vaccines used to prevent diseases. Vaccine treatment for melanoma might involve injecting altered cancer cells into the body to draw the attention of the immune system.
Adopted from Mayoclinic.com